Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CLINICAL CHEMISTRY > RENAL > Flashcards

RENAL Flashcards

You may prefer our related Brainscape-certified flashcards:
AP® Chemistry flashcards Periodic Table flashcards Chemistry 101 flashcards Organic Chemistry 101 flashcards
1
Q

Describe the gross anatomy of the Kidney

A

The Kidneys are paired bean shaped organs found on the retroperitoneum covered by A renal Fibrous capsule.
It has two parts, The cortex and medulla.
The cortex contains nephrons while the medulla contains renal pyramids and collecting duct.
The hilum of the Kidney contain the renal artery, vein and ureter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the
1) Renal blood flow
2) GFR

A

1200ml/min
125 ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percentage of cardiac output goes to the Kidney

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give the Renal functions

A

1) Filtration of blood
2) Excretion of metabolites, drugs and toxins
3) Regulation of fluid, electrolytes and blood pressure
4) Secretion of EPO in response to hypoxemia
5) Activation of Vitamin D
6) Degradation of hormones such as Insulin , Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Adequate Renal function is dependent on three main factors, name them.

A

1) Adequate blood supply
2) Integrity of the nephrons
3) Normal secretion and feedback control of hormones acting on the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe Renal Failure

A

When the Kidney can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give two other names of Renal failure

A

Kidney disease
End stage Kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

End stage Kidney disease may divided into

A

Acute Kindey Injury
Chronic Kidney Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some signs and symptoms of Renal failure

A

Due to uremia
1) Vomiting , diarrhea
2) Less or more urination
3) Hematuria
Due to potassium build up / hyperkalemia.
1) Abnormal heart rhythms
2) Muscle paralysis
Due to phosphate build up
1) Itching
2) Bone damage
3) Muscle damage due to low calcium
Edema
Anemia due to low levels of EPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe Acute Kidney Injury

A

Sudden loss of Kidney function occuring within a few hours to days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute Kidney Injury has three phases , list

A

1) Oliguric or Anuric
2) Diuretic
3) Recovery phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the oliguric phase of AKI

A

1) Oliguric or Anuric develops within 7 days and is marked by a decrease in urine output.

This is usually due to decreased GFR and can lead to
1) increased BUN and creatinine levels - confusion
2) Hyperkalemia - cardiac arrhythmias
3) Edema – fluid accumulation due to reduced waste
4) Metabolic acidosis - decreased H+ excretion, Kussmaul breathing as compensation to decrease the blood acidity by removing carbon dioxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the Diuretic phase of AKI

A

Develops one to three weeks after kidney injury.
Usually, a road to recovery where the Kidney is beginning to function properly. Since there were already high urea levels, the kidney’s attempt in excreting this will lead to osmotic diuresis due to increased urine osmolality.
This can lead to dehydration, hypovolemia and hypotension and hypokalemia..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the Recovery phase of AKI

A

Can last from several months to years.
Marked by normal functioning kidneys and normal BUN and creatinine levels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The types of AKI causes are classified into.

A

1) Pre-renal - decreased blood flow
2) Renal - damage of kidney itself
3) Post renal - due to blockage of urine flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give the Pre-renal cause of AKI

A

1) Hypovolemia due to dehydration, burns , bleeding
2) Hypotension - due to shock , sepsis , or heart failure
3) Renal artery stenosis - atheroma or thrombosis
4) NSAIDS
5) cirrhosis - hepatorenal syndrome
6) Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give the Intrinsic renal causes in AKI

A

Acute glomerulonephritis
Acute tubular necrosis
Lupus nephritis
Nephrotoxic drugs such as NSAIDS , Aminoglycosides antibiotics , contrast dye
Injury to kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give the Post Renal causes of AKI

A

Kidney stones
Bladder cancer
Enlargement of prostate - obstruct the urethra in males.
Narrowing of the urethra
Anticholinergics - urinary retention
Neurogenic bladder - damage to nerves that control bladder function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe Chronic Kidney Disease (ckd)

A

Decreased renal function over a period of months to years , usually over three months

19
Q

Give the stages if renal dysfunction

A

1) Normal or increased GFR gfr>90% with proteinuria (>90ml/min/1.73m2)
2) Early renal insufficieny 60-89%
3) Modeerately decreased GFR 30 -59%)
4) Severe Renal failure (GFR 15-29)
5) ESRD (<15%)

20
Q

What are the metabolic derangements in Renal Failure

A

Increased K , Mg , PO ,
Increased Urea , Creatinine and UA
Decreased Na,Cl,Ca,HCO3
Metabolic acidosis
Proteinuria

21
Q

In addition to Proteinuria, MB acidosis and other electrolyte derangements in renal failure, CKD presents with three other derangements , name them

A

1) Endocrine derangements
2)Dyslipidemia
3) Fixed urine osmolality

22
Q

Give the Endocrine derangements in CKD.

A

1) Secondary hyperparathyroidism
2) Reduced Vit d3
3) Reduced EPO
4) Reduced insulin degradation and insulin resistance

23
Q

Briefly explain how renal failure causes secondary hyperparathyroidism

A

In CKD the kidney is unable to properly remove phosphorus from the body increasing its serum levels. This reduces calcium levels as phosphorus binds to calcium forming insoluble salts.

This created a feedback mechanism in which PTH is released to increase more calcium levels from bone resorption.

24
Q

Describe fixed fluid osmolality

A

The concentration of solutes remain constant in urine despite increased fluid intake

25
Q

What is azotemia

A

Increased levels of nitrogenous compounds such as urea and creatinine in the blood usually de to abnormal kidney function.

26
Q

Give 6 examples of Kidney function tests

A

1) BUN (blood urea nitrogen)
2) Creatinine
3) Urinalysis
4) Kidney ultrasound
5) Kidney biopsy
6) Electrolyte blood tests

27
Q

What are the normal serum creatinine levels in mg/dl

A

0.6 -1.20 mg/dl

28
Q

What is creatinine?

A

A waste product from muscle metabolism

29
Q

Creatinine is reabsorbed, True or False

A

False

30
Q

Why is Creatinine efficient in determining the GFR

A

It is not reabsorbed once it is filtered out

31
Q

In order to determine GFR using creatinine, what should be considered about the patient?

A

The age , race and gender

32
Q

What is the normal BUN in mg/dl

A

6-20mg/dl

34
Q

Give two main causes of CKD

A

1) Diabetes Mellitus
2) Hypertension

35
Q

How does DM cause CKD

A

The high levels of glucose stick to the small blood vessels supplying the kidneys causing damage and thus reduced renal blood flow and GFR.

36
Q

Give atleast 6 cases of CKD

A

1)DM
2)Hypertension
3)Polycystic Kidney disease
4)Kidney stones
5)Nephrotoxic drugs such as NSAIDS, Aminoglycosides
, contrast dye
6)Glomerulonephritis
7) SLE

37
Q

Give the relationship between CKD and Renal osteodystrophy / renal bone disease/ mineral bone disease (MBD)

A

1) The kidneys activate Vitamin D to its active form calcitriol which help in the absorption of calcium and phosphorus from the diet.
Thus, in the case of CKD , reduced kidney function leads to reduced calcitriol formation and thus hypocalcemia.

2) Hypocalcemia is also due to increased phosphate which binds to calcium in blood causing reduced calcium levels.

3) This hypocalcemia stimulates the parathyroid hormones (secondary hyperparathyroidism) to release calcium from bones thus bone weakness.

38
Q

Define Nephrolithiasis

A

Formation of stones in the kidney or urinary tract

39
Q

What are kidney stones?

A

Hard insoluble crystals of mineral and salts formed from the renal filtrate.

40
Q

Give examples of 6 types of Kidney stones

A

1) Calcium oxalate stones (80%) due to high calcium and oxalate
2) Uric acid stones -such as in gout due to high uric acid
3)Struvite stones - magnesium, ammonium and phosphate usually in response to certain types of infections.
4) Cystine stones -
5) Calcium phosphate stones
6) Mixed stones

41
Q

Define RRT

A

Renal replacement therapy includes modalities of treatment used to replace the waste filtering functions of the kidney

42
Q

Give the Indications of RRT

A

AKI
CKD
Sevre fluid overload
Severe electrolyte imbalances
Toxins removable by dialysis

43
Q

Give examples of RRT

A

1) Hemofiltration
2) Hemodialysis
3) Peritoneal dialysis
4) Renal transplant

44
Q

Give some derangements that may occur wit Hemodialysis

A

Hypocalcemia
Hypoproteinemia
Hyperglycemia

45
Q

What tests can be used in measuring effectiveness of dialysis

A

1) Urea reduction ratio
2) Kt/V

CLINICAL CHEMISTRY (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions